| NPI | 1790405645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: NM 64164) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM 64164) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2023-06-08 |